The present invention is directed to a detection device adapted to be attached to the distal end of an endotracheal tube for verifying the proper intubation of the endotracheal tube within the airway of a patient, and in particular to a detection device having a housing with a gripping member at the proximal end of the housing and a plunger that is adapted to be withdrawn from the housing along a longitudinal axis that is disposed generally at a right angle to the endotracheal tube.
Endotracheal tubes are intended to be intubated within the trachea of a patient in order to ventilate the patient. The trachea is a relatively rigid tube that forms an airway for passing air to the lungs. The esophagus is a flexible muscular tube located between the trachea and the spinal cord that leads to the stomach. Thus the trachea is an airway passage to the lungs and the esophagus is a passage to the stomach for food and fluids. In order to ventilate a patient it is imperative that the endotracheal tube be intubated within the trachea that forms the airway, rather than within the esophagus. Even when the endotracheal tube is located within the trachea, as opposed to the esophagus, it is also important that the endotracheal tube be properly positioned within the trachea.
The anatomical differences between the relatively rigid trachea and the relatively flexible esophagus have led to the development of two general types of devices for verifying the proper placement of an endotracheal tube within the airway or trachea of a patient. These are the bulb-type device and the syringe-type device. Once the endotracheal tube has been intubated, the bulb-type device requires the medical attendant to squeeze the bulb of the bulb-type device prior to attaching the bulb-type device to the distal end of the endotracheal tube. After attachment, the bulb is released, and the bulb will try to expand and draw air through the endotracheal tube into the bulb. If the endotracheal tube is improperly intubated within the esophagus, the flexible wall of the esophagus will collapse and thereby prevent air from flowing through the endotracheal tube into the bulb and thereby preventing the bulb from fully expanding. If the endotracheal tube is properly intubated in the trachea, the rigid wall of the trachea will not collapse and the bulb will draw air through the endotracheal tube and the bulb will fully reexpand.
Use of the bulb-type device has provided false readings. Such false readings have been obtained when the medical attendant fails to squeeze the bulb before attaching the bulb-type device to the endotracheal tube, but instead squeezes the bulb after attachment to the endotracheal tube such that fifty to sixty milliliters of air are introduced into the patient. If the endotracheal tube was improperly intubated within the esophagus, the air pocket formed by the introduced air does not allow the esophagus to collapse properly to provide an indication that the endotracheal tube is improperly placed in the esophagus.
The syringe-type device does not require the pre-squeezing of a bulb and the use of the syringe-type device results in negligible false readings. The syringe-type device requires the medical attendant to attach the device to the distal end of the endotracheal tube and then pull back on the plunger of the syringe. If the endotracheal tube is properly intubated in the trachea, the plunger will pull back easily. If the endotracheal tube is improperly intubated in the esophagus the plunger will draw a vacuum collapsing the esophagus and thereby making withdrawal of the plunger difficult.
Prior syringe-type devices have caused endotracheal tubes that are initially properly intubated and properly positioned within the trachea to become misplaced within the trachea, that is, inserted too far or not inserted far enough into the trachea. The plungers of prior syringe-type devices are orientated generally coaxially to the distal end of the endotracheal tube, such that the withdrawal force applied to the plunger also acts to withdraw the endotracheal tube from the patient. Withdrawal of the endotracheal tube from the trachea by as little as one or two centimeters can make the difference between a properly placed endotracheal tube and a second attempt at intubation. Thus the bulb-type devices and the prior syringe-type devices both expose the patient to the risk of an unwanted extubation of an endotracheal tube and a second intubation of the endotracheal tube. The present invention greatly reduces these risks.